Prior Authorization Specialist/Licensed Practical Nurse
Spectra Health•Grand Forks, ND
293d•Hybrid
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About The Position
The Prior Authorization Specialist is responsible for all aspects of the prior authorization process, which includes reviewing and interpreting medical record documentation for patient history, diagnosis, and previous treatment plans. Utilizes payer-specific approved criteria to determine medical necessity or the clinical appropriateness for the company's products. Submits pertinent demographic and supporting clinical documentation with authorization requests timely to avoid unnecessary delays in patient treatment. The Prior Authorization Specialist reports directly to the Medical Clinic Manager.
